•

FREE TO TAKE HOME! OCTOBER-NOVEMBER 2018 EDITION

ENJOY THIS FREE NEWSLETTERPlease remember that decisions about medical care should be made in consultation with your health care provider so discuss with your doctor before acting on any of the information. www.healthnews.net.au

Your next appointment:

Tinnitus

Asthma in children

Managing stress

Baby teeth

Practice DoctorsDr Melinda GriffithsBMBS, Dip Paeds, FRACGP

Dr Bradley ForssmanMBBS, MPHTM, FAFPHM

Dr Hamish McArthurBSc(Hons), BMBS, FRACGP

Dr Carole ChungBMedSc, MBBS, Dip Paeds, FRACGP

Dr Marc MadeleineBMedSc, MBBS(Hons), Dip Paeds, FRACGP

Dr Simon CowapMBBS(Hons), FRACGP

Dr Sharon LimMBBS, Dip Paeds, FRACGP

Dr Penelope ElixBMedSc(Hons), MBBS, DRANZCOG, DCH, FRACGP

Dr Rebecca BlakeBSc(Med), MBBS, FRACGP, MPH

Dr Jennifer Morrison BA, MBBS(Hons), DCH, MPH, FRACGP

Dr Lan-Yi (Nancy) YiinBSc(Med), MBBS, FRACGP

Dr Brian Lim Min Loong BSc(Med), MBBS, FRACGP

Dr Sofie RobertsMBBS(Hons), FRACGP

oUr Practice iNterests• Women’s & Men’s Health • Mental Health• Paediatrics (Children’s Medicine) • Family Planning & Antenatal

Shared Care• Travel Medicine • Preventative Health• Aviation Medicine • Skin Cancer• Sexual Health & HIV Medicine

aDMiNistratioN staFFPractice Nurses: Anne Maree, Maureen, Rowena & JenPractice Manager: LeanneReception: Lyn, Kim, Siobhan, Rebecca, Corrina, Charlotte, Linda & Sam

Surgery HourSMonday-Friday: ........8.00am-6.00pm Saturday: .................9.00am-12noon

After HourS 6pm-8am Weekdays. 12 midday Saturdays-8am Mondays and Public Holidays please contact our locum service on 8724 6300. (Bulk billed for Medicare holders).For urgent medical attention at anytime dial 000 or go directly to the nearest hospital Emergency Department.Australian Government After Hours GP Helpline 1800 022 222.

Billing ArrAngementSThis practice is a private billing practice and reflects the quality of our care and service. Fees are payable at the time of consultation by either cash, EFTPOS, Mastercard, Visa or Amex. Our billing information is displayed in the reception area of the surgery. For convenience, we can offer patients a Medicare Online Claiming service, eliminating the need to visit a Medicare office.

AppointmentSWe are by appointment only, so that our patients have adequate time with their chosen doctor.Home visits are available in certain circumstances by appointment.Booking a long appointment. If you require an insurance medical, review of a complex health problem, counselling for emotional difficulties, or a second opinion, please book a longer appointment. Emergency appointments. Each day appointments are set aside by the doctors for patients who need to be seen urgently. All doctors have access to your medical records if your usual GP is not available and can liaise with each other if necessary. This allows you to be seen on the day when required.Online bookings now available for existing patients. We offer an online booking service for our existing patients through HotDoc via our website www.fountaingp.com.au . Please note that this is an automated system and appointments can be rejected for various reasons. If there is an issue or you are unsure about an appointment booked, please call the practice on 8303 2900 so we can help to resolve the problem. If your Online booking has been successful you will receive an email confirmation.Patients can also download the HotDoc app on their mobile phone or android.Childhood Immunisation and New Patient appointments cannot be booked online, please call us on 8303 2900 during opening hours for these appointments.Why not check out our recently updated website www.fountaingp.com.au for more information.

online repeAt preScriptionS And referrAlSWe have an online service for ordering your repeat prescriptions and repeat referrals through HotDoc via our website. Please visit www.fountaingp.com.au for more information.

21 Fountain Street, Alexandria NSW 2015Phone 8303 2900 | Fax 9699 9686www.fountaingp.com.au

SPECIAL PRACTICE NOTESContacting the doctor: The doctor will take calls if he or she is not in consultation. However if the doctor is not available and the nature of the matter is urgent patient’s will be put through to the Practice Nurse who will discuss the nature of the enquiry and determine the best course of action.Our practice does not communicate with patients via email. Please phone our practice on 02 8303 2900.Our practice Privacy Statement is available in hard copy – please ask for a copy at our front deskRequests for Referrals & Scripts Without Consultation. Occasionally, it may be appropriate for your doctor to provide a repeat referral or a script without a consultation. An online service is available for these situations at www.fountaingp.com.au via HotDoc. Some requests cannot be completed without a consultation and will require an appointment, this includes requests for new medications or a new referral.Reminder System. Our practice is committed to preventative care. We may issue you with a reminder letter or send an SMS periodically offering you preventative health services appropriate to your care. We also encourage our patients to participate in initiatives such as the The NSW Pap Test Register, National Bowel Cancer Screening Program Register and the Australian Childhood Immunisation Register. If you don’t wish to be part of this system, just advise your doctor or reception staff.Results of Tests or Procedures. Patients are required to book a follow-up unless otherwise advised by the doctor. Your doctor will advise when they expect results to arrive. On occasion you may receive your results via phone, either from your doctor or the practice nurse. This is at the doctors discretion.Your Rights. Staff and doctors are always open to receiving your suggestions/complaints and will respond appropriately. If required, you can contact: Health Care Complaints Commission. Tel: 02 9219 7444 or Toll Free in NSW 1800 043 159. TTY service for the hearing impaired: 02 9219 7555. Postal address: Locked Mail Bag 18, Strawberry Hills NSW 2012. hccc@hccc.nsw.gov.auInterpreter Service. Fountain Street General Practice provides an Interpreting Service (TIS National) for non-English speaking Australian citizens and permanent residents. Please see the Rear Cover for more practice information.

When head noises get in the way – tinnitus

About 30-40% of people with tinnitus suffer socially and in the workplace. Negative thoughts and emotions can create a vicious cycle that accentuates tinnitus symptoms. Your doctor will probably want to know if you are curious, concerned or distressed about your tinnitus or if you have associated dizziness.

We know tinnitus is more common in people with a hearing loss or other ear problems. Your doctor may refer you to someone with specialised equipment or expertise. They may provide information and look at self-directed treatment options.

Alternatively, information may be provided by an audiologist who will ask if the problem is intermittent or persistent, if dizziness is associated with it or if there is hearing loss. The situation may be simple or complex, and it may take multiple investigations by different clinicians to get to the bottom of it. Fortunately, symptoms

are not usually a sign of severe disease, such as a brain tumour.

How an individual thinks and feels about tinnitus is important. It would be negligent if anxiety, depression and sleep problems were not asked about.

Often nothing gets rid of it. However, patients can successfully manage their tinnitus using different treatments to the point where it is no longer a concern. Common suggestions for management include avoiding silence, doing things to keep calm and relaxed, and limiting caffeine. Removing excessive earwax can also help.

From the doctor’s perspective, some medications can cause or worsen tinnitus – aspirin, quinine, some antibiotics, diuretics and some anti-cancer drugs are the most well-known.

We are told celebrities that have suffered from tinnitus include Liza Minelli, Bob Dylan, William Shatner and Barbara Streisand.

About one in five people have ‘head noises’ or tinnitus that annoys them. Most of us have noise in our hearing system, so it is how we focus on the problem that gets us in strife. This is a real dilemma for those helping – focus on what to do to overcome the problem, and if you can’t overcome it, risk increasing someone’s distress by increasing their focus on their tinnitus!

Weblink: www.tinnitus.asn.au

Asthma in children

Uncontrolled asthma can be fatal. However, asthma can be successfully managed and controlled through use of medication. Children with asthma can live a completely normal life and do not need to be restricted in their sporting or other activities.

It is estimated that as many as one on five children will be diagnosed with asthma. It can range from mild to severe. Some children have symptoms all year round while others only in certain circumstances (e.g. a viral illness or when exposed to irritants like dust or grass).

Typical symptoms include a wheeze and cough. In more severe cases there may be chest tightness and shortness of breath. Diagnosis is by the history of symptoms and examination of the lungs. Lung function testing is helpful but can prove normal when asthma is dormant.

Asthma is generally treated with inhalers of which there are two mainstays – preventer and symptom relievers. The former is used on a regular basis to treat the underlying inflammation in the airways and the latter to improve symptoms as needed. In severe cases oral steroids may be used in short bursts.

Tinnitus only drives a minority of sufferers mad!

Younger children often are not frightened by a spacer mask, if it is

introduced as a toy and the parents are involved.

Weblink: www.asthmafoundation.org.au

SUDUKU SOLUTION

412356987

539478162

867129534

793284615

285761349

146935278

358697421

671542893

924813756

The treatment rationale is to use the lowest dose necessary to control the condition, so doses will not be constant through the year.

For parents, the key is to recognise the pattern on your child’s asthma – its triggers and symptoms. So it is important to have an asthma plan (available from the National Asthma Council) and to have your child checked regularly by your GP.

Most importantly, seek urgent medical attention if there is any worsening of the condition.

Managing stress in busy lives It doesn’t seem to matter who you talk to, everyone feels stressed at some stage of their lives. Relationships, money and work are consistently shown in polling to be the big three worriers. Our body reacts to stress today as it did in caveman days. It goes into fight or flight mode with the release of hormones such as adrenalin and cortisol which were helpful when the threat had a physical solution and would end (for better or worse). It is not so helpful with the type of stressors we face today.However, there is much we can do to manage stress, starting with regular exercise. It can be as simple as going for a walk. Listening to calming music, doing slow, deep breathing or guided meditations can be helpful as well. There are many digital apps available to help people deal with stress and many are free. Drinking herbal tea helps some people as does keeping a journal. Drink mainly water and do not drink alcohol to excess. Try to minimise sugar in your diet. Taking a short vacation, if possible, may help.

Ultimately dealing with what stresses you is the key. Remember you don’t always have to do this alone. For many, chatting with your GP or a counsellor can be beneficial, as can talking with trusted friends or family. Others may see solutions that you don’t.

Stress can lead to mental health problems, so see your GP if you have any concerns.

When one considers that the average life expectancy is over 82 years, it seems odd that we get two sets of teeth but the first set lasts only until we are 10 or so. Baby teeth develop while still in the womb and we are born with 20 hidden in the gums. Our 32 adult teeth will replace the baby set between the ages of six and 20.The first teeth can appear as early as three months and as late as 12 months and in any order, though the central ones are usually first.

Teething gets a bad rap and, to be fair, it can be distressing. Equally, much gets blamed on teething which has nothing to do with them. Typical symptoms of teething are crying, dribbling and pulling on ears. Some babies may put their hands in their mouths. If your child is unwell or has a fever, go to your GP rather than assume it is due to teething.

For symptom relief, teething rings can be very helpful. You can also use paracetamol, ibuprofen and teething gels. Be prepared to do some trial and error to find what works for your child.

You can start cleaning teeth once they appear using a soft baby toothbrush with water only, and start baby toothpaste at 18 months.

Sugar is bad for teeth so minimise this and you can start regular dental checks from 12 months.

The condition comes about from nerve cells ceasing to produce enough dopamine, a chemical which sends message between cells. When those messages are blocked, muscle control is impeded. Why this happens is not clear. Family history is one risk factor as is head trauma and exposure to pesticides.

Diagnosis is based on history and examination. There is no specific blood or imaging test for diagnosis. Brain scans are generally normal. Given the slow onset of symptoms it can take some time for an exact diagnosis to be made.

Treatment is focused on maintaining function. A healthy diet and keeping active are important. Physiotherapy, to establish and guide an exercise program that includes daily stretching, helps. Medications can control the condition but not cure it. As time goes by their effectiveness can lessen

and dosages need to be increased. Side effects can also be a problem for some.

No two people will have the exact same experience, so treatment is always individualised. There are state and national support groups to assist.

Weblink: http://raisingchildren.net.au/articles/dental_care_babies.html

www.ada.org.au

Parkinson’s disease An estimated 40,000 Australians have Parkinson’s disease – a progressive degenerative neurological condition which affects the control of body movements. Typical symptoms are trembling of the hands, arms, legs and face, together with slowing of movement, instability, tiredness and difficulty walking. It comes on gradually and early signs may be very subtle.

Baby teeth – what you need to know

A late sign is the smile. It is replaced by an expressionless stare. Weblink: http://www.parkinsons.org.au/

•

Preheat oven 200 CIngredients2 x Bunches Baby Carrots – trimmed and

washed

6 x Medium Beets – peeled & cut into wedges

4 x Parsnips – peeled and cut into wedges

2 x Spanish Onion – cut into wedges

2 x Large Sweet Potatoes – Peel & cut into ¾

inch cubes

1 x Celeriac – Remove skin & cut into small

wedges. Place in a bowl of water with lemon

wedges to prevent browning

6 x Cloves garlic – peeled

1 x Lemon cut into wedges

1 x 75gms Baby Spinach leaves

1 x 200g Greek-style feta, cubed

MethodPut all prepared vegetables in a bowl and toss

with 3 tablespoons olive oil.

Place in a single layer on a baking tray.

Sprinkle with salt and pepper.

Bake for approx 30 minutes or until just

tender.

Let cool completely.

Toss the vegetables with baby spinach leaves

and feta cheese.

DressingWhisk together 1/3 cup olive oil, 3

tablespoons balsamic vinegar, 1 clove crushed

garlic & 1 teaspoon brown sugar.

Serve salad drizzled with dressing.

ROASTED ROOT VEGETABLE & FETA SALAD (SERVES 6)

SUDOKU

5 3 6

7 9 5 3 4

8 1

2 6 9

1 2 7

8 6 1

6 4 2 8

5

QUIZ What two things can tinnitus be associated with?

A spacer is the best way of delivering puffer spray to young children - check with your doctor if one is needed.

One of the late signs of Parkinson’s Disease can be an expressionless stare - True or False?

What is meant by “deciduous” teeth - an older term?

Practice DoctorsDr Melinda GriffithsBMBS, Dip Paeds, FRACGP

Dr Bradley ForssmanMBBS, MPHTM, FAFPHM

Dr Hamish McArthurBSc(Hons), BMBS, FRACGP

Dr Carole ChungBMedSc, MBBS, Dip Paeds, FRACGP

Dr Marc MadeleineBMedSc, MBBS(Hons), Dip Paeds, FRACGP

Dr Simon CowapMBBS(Hons), FRACGP

Dr Sharon LimMBBS, Dip Paeds, FRACGP

Dr Penelope ElixBMedSc(Hons), MBBS, DRANZCOG, DCH, FRACGP

Dr Rebecca BlakeBSc(Med), MBBS, FRACGP, MPH

Dr Jennifer Morrison BA, MBBS(Hons), DCH, MPH, FRACGP

Dr Lan-Yi (Nancy) YiinBSc(Med), MBBS, FRACGP

Dr Brian Lim Min Loong BSc(Med), MBBS, FRACGP

Dr Sofie RobertsMBBS(Hons), FRACGP

oUr Practice iNterests• Women’s & Men’s Health • Mental Health• Paediatrics (Children’s Medicine) • Family Planning & Antenatal

Shared Care• Travel Medicine • Preventative Health• Aviation Medicine • Skin Cancer• Sexual Health & HIV Medicine

aDMiNistratioN staFFPractice Nurses: Anne Maree, Maureen, Rowena & JenPractice Manager: LeanneReception: Lyn, Kim, Siobhan, Rebecca, Corrina, Charlotte, Linda & Sam

Surgery HourSMonday-Friday: ........8.00am-6.00pm Saturday: .................9.00am-12noon

After HourS 6pm-8am Weekdays. 12 midday Saturdays-8am Mondays and Public Holidays please contact our locum service on 8724 6300. (Bulk billed for Medicare holders).For urgent medical attention at anytime dial 000 or go directly to the nearest hospital Emergency Department.Australian Government After Hours GP Helpline 1800 022 222.

Billing ArrAngementSThis practice is a private billing practice and reflects the quality of our care and service. Fees are payable at the time of consultation by either cash, EFTPOS, Mastercard, Visa or Amex. Our billing information is displayed in the reception area of the surgery. For convenience, we can offer patients a Medicare Online Claiming service, eliminating the need to visit a Medicare office.

AppointmentSWe are by appointment only, so that our patients have adequate time with their chosen doctor.Home visits are available in certain circumstances by appointment.Booking a long appointment. If you require an insurance medical, review of a complex health problem, counselling for emotional difficulties, or a second opinion, please book a longer appointment. Emergency appointments. Each day appointments are set aside by the doctors for patients who need to be seen urgently. All doctors have access to your medical records if your usual GP is not available and can liaise with each other if necessary. This allows you to be seen on the day when required.Online bookings now available for existing patients. We offer an online booking service for our existing patients through HotDoc via our website www.fountaingp.com.au . Please note that this is an automated system and appointments can be rejected for various reasons. If there is an issue or you are unsure about an appointment booked, please call the practice on 8303 2900 so we can help to resolve the problem. If your Online booking has been successful you will receive an email confirmation.Patients can also download the HotDoc app on their mobile phone or android.Childhood Immunisation and New Patient appointments cannot be booked online, please call us on 8303 2900 during opening hours for these appointments.Why not check out our recently updated website www.fountaingp.com.au for more information.

online repeAt preScriptionS And referrAlSWe have an online service for ordering your repeat prescriptions and repeat referrals through HotDoc via our website. Please visit www.fountaingp.com.au for more information.

21 Fountain Street, Alexandria NSW 2015Phone 8303 2900 | Fax 9699 9686www.fountaingp.com.au

SPECIAL PRACTICE NOTESContacting the doctor: The doctor will take calls if he or she is not in consultation. However if the doctor is not available and the nature of the matter is urgent patient’s will be put through to the Practice Nurse who will discuss the nature of the enquiry and determine the best course of action.Our practice does not communicate with patients via email. Please phone our practice on 02 8303 2900.Our practice Privacy Statement is available in hard copy – please ask for a copy at our front deskRequests for Referrals & Scripts Without Consultation. Occasionally, it may be appropriate for your doctor to provide a repeat referral or a script without a consultation. An online service is available for these situations at www.fountaingp.com.au via HotDoc. Some requests cannot be completed without a consultation and will require an appointment, this includes requests for new medications or a new referral.Reminder System. Our practice is committed to preventative care. We may issue you with a reminder letter or send an SMS periodically offering you preventative health services appropriate to your care. We also encourage our patients to participate in initiatives such as the The NSW Pap Test Register, National Bowel Cancer Screening Program Register and the Australian Childhood Immunisation Register. If you don’t wish to be part of this system, just advise your doctor or reception staff.Results of Tests or Procedures. Patients are required to book a follow-up unless otherwise advised by the doctor. Your doctor will advise when they expect results to arrive. On occasion you may receive your results via phone, either from your doctor or the practice nurse. This is at the doctors discretion.Your Rights. Staff and doctors are always open to receiving your suggestions/complaints and will respond appropriately. If required, you can contact: Health Care Complaints Commission. Tel: 02 9219 7444 or Toll Free in NSW 1800 043 159. TTY service for the hearing impaired: 02 9219 7555. Postal address: Locked Mail Bag 18, Strawberry Hills NSW 2012. hccc@hccc.nsw.gov.auInterpreter Service. Fountain Street General Practice provides an Interpreting Service (TIS National) for non-English speaking Australian citizens and permanent residents. Please see the Rear Cover for more practice information.